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. Author manuscript; available in PMC: 2022 Nov 14.
Published in final edited form as: JACC Clin Electrophysiol. 2022 Sep 28;8(10):1191–1215. doi: 10.1016/j.jacep.2022.07.003

FIGURE 1. Panoramic 3-Dimensional Reconstruction of SAN Autonomic Innervation.

FIGURE 1

The image shows the area from the superior vena cava (SVC) (right side of the image) to the inferior vena cava (IVC) (left side of the image) and from the septum to the crista terminalis. The “head” of the hyperpolarization-activated cyclic nucleotide-gated channel 4–positive pacemaker cell meshwork forms around the root of the SVC; the “body” of the meshwork continues along the course of the sinoatrial nodal (SAN) artery, forming the “tail” that extends to the root of the IVC. The image presents all adrenergic (tyrosine hydroxylase; cyan) and cholinergic (vesicular acetylcholine transporter; green) fibers within the SAN and right auricle. The neuronal plexus enwrapped the hyperpolarization-activated cyclic nucleotide-gated channel 4–positive immunoreactive meshwork (red color) and penetrated into the pectinate muscles of the right auricle. Cardiac ganglia (yellow arrow at the bottom of the figure) were located near the epicardial side of the septum. Red arrows point to nerves emanating from these ganglia, which penetrated the tissue.